How to uphold patient dignity at the end of life

Posted 1 December 2016byMatthew

by Heather Wiseman, Palliative Care Australia, 15 November 2016

Dr Harvey Max Chochinov is a distinguished professor of psychiatry at the University of Manitoba, director of the Manitoba Palliative Care Research Unit and leader of the research team that pioneered the Dignity Model.

Ms Wiseman reports on his recent talks in Australia to discuss the issue of dignity in end of life care.

Of the many findings that have stemmed from Dr Harvey Max Chochinov’s extensive research into dignity, there is one he describes as intriguing and the source of a personal epiphany.

It is that people who are dying are profoundly influenced by their perceptions of how they are seen by others. They need to see, reflected in the eyes and actions of those caring for them, recognition of the person they are. Dignity is lost when a focus on their illness or disease leaves them with the sense they have been defined generically as a patient and that is all they have become.

“It boils down to ‘I’m not just a patient; but a person with a history, relationships, a past, desires and dreams’,” Dr Chochinov says.

Dr Chochinov says the early stages of his research were inspired 25 years ago by literature coming out from Holland. It indicated loss of dignity was the reason why most patients received euthanasia or assisted suicide.

“At that point in time no one had studied the issue of dying with dignity, to look at what patients’ experiences were that reinforced or undermined dignity. Over time we have looked at those influences, including physical, psychological spiritual and psycho-social issues.”

He says his research shows people experiencing a loss of dignity have significantly higher rates of depression, anxiety and feelings of hopelessness.